Time can be important in an emergency department especially in a busy Level 1 Trauma Center like MetroHealth Medical Center in Cleveland, when getting patients appropriate care is essential. However, when the quality of an emergency department is judged by a patient''s length of stay, time takes on a new meaning.

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A study published in The Journal of the American Medical Association (JAMA) found that there is no significant difference between safety-net and non-safety-net hospitals when it comes to the length of stay for emergency patients.

In an accompanying JAMA editorial, Charles Emerman, MD, FAAEM, Chair of the Department of Emergency Medicine at MetroHealth and Professor of Emergency Medicine at Case Western Reserve University School of Medicine, discusses the challenges and opportunities of reporting time-to-treatment measures within emergency departments.

"Measuring quality in an emergency department can be very complex," said Dr. Emerman. "Modern departments face many challenges including an increase in patient visits combined with a decreasing number of emergency departments across the country as well as the proposed financial penalties associated with readmissions and key quality measures."

The editorial discusses how quality improvement initiatives for emergency departments should be based on measures that will improve patient outcomes. He believes that quality in emergency departments will improve greatly in hospitals that focus on changes both within and outside of the department along with supplying them with the necessary resources to care for increasing numbers and complexity of patients.

Under Dr. Emerman''s leadership, MetroHealth''s Emergency Department is making important changes to create a quality environment including new Rapid Treatment Rooms that were added in October 2011 and improving processes in the department by incorporating industrial strategies to streamline patient flow.

By focusing on patient flow, proper staffing and utilization of the hospital''s short stay unit for patients with conditions expected to resolve in a few days, MetroHealth''s Emergency Department has: - Maintained a "left without being seen" rate that is much lower than the national benchmark;- Discharged patients in an average of 4.1 hours, well below the national average of 4.5 hours at similar hospitals;- Treated a record-breaking 100,000 patients last year.

"The increase in patient visits in our Emergency Department show that we are known for quality of care and our efficiency," said Dr. Emerman. "We will continue to be a leader in emergency care and continue to improve our care for the benefit of our patients and our community."

About The MetroHealth System Celebrating 175 years of service in 2012, The MetroHealth System is a comprehensive academic healthcare system which serves as the safety net public hospital for Northeast Ohio. MetroHealth has a nationally renowned Level I trauma and burn center and an acclaimed critical-care transport program - Metro Life Flight. MetroHealth''s network of health centers incorporates a patient-centered medical home team care approach to optimize patient outcomes through chronic disease management. Founded in 1837, MetroHealth has been a major affiliate of Case Western Reserve University since 1914 and all MetroHealth active physician staff hold faculty appointments at Case Western Reserve University School of Medicine. MetroHealth provides one million inpatient and outpatient visits - with overall revenue of $800 million. For more information on The MetroHealth System, visit www.metrohealth.org.

About Case Western Reserve University School of Medicine Founded in 1843, Case Western Reserve University School of Medicine is the largest medical research institution in Ohio and is among the nation''s top medical schools for research funding from the National Institutes of Health. The School of Medicine is recognized throughout the international medical community for outstanding achievements in teaching. The School''s innovative and pioneering Western Reserve2 curriculum interweaves four themes--research and scholarship, clinical mastery, leadership, and civic professionalism--to prepare students for the practice of evidence-based medicine in the rapidly changing health care environment of the 21st century. Nine Nobel Laureates have been affiliated with the school of medicine.

Annually, the School of Medicine trains more than 800 MD and MD/PhD students and ranks in the top 25 among U.S. research-oriented medical schools as designated by U.S. News & World Report "Guide to Graduate Education."

The School of Medicine''s primary affiliate is University Hospitals Case Medical Center and is additionally affiliated with MetroHealth Medical Center, the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, and the Cleveland Clinic, with which it established the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in 2002. http://casemed.case.edu.

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